Iron Overload Accelerates Bone Loss in Healthy Postmenopausal Women and Middle-Aged Men: A 3-Year Retrospective Longitudinal Study
Iron Overload Accelerates Bone Loss in Healthy Postmenopausal Women and Middle-Aged Men: A 3-Year Retrospective Longitudinal Study
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DOI：
10.1002/jbmr.1692
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发表时间：
2012-11-01
影响因子：
6.2
通讯作者：
Kim, Ghi Su
中科院分区：
文献类型：
--
作者：
Kim, Beom-Jun;Ahn, Seong Hee;Kim, Ghi Su
尽管大量的实验和动物证据表明铁及其超载对骨代谢的有害影响，但还没有关于铁储存与骨质流失的临床研究，特别是在非病理性条件下。在本研究中，我们进行了一项大型纵向研究，以评估健康韩国人血清铁蛋白浓度与骨密度（BMD）年化变化的关系。共有1729名年龄在40岁及以上的受试者（绝经后女性940名，中年男性789名）接受了平均随访3年的全面常规健康检查。在基线和随访时使用相同的设备，用双能x线吸收仪测量股骨近端部位（即全股骨、股骨颈和股骨粗隆）的骨密度。该研究中女性和男性的平均年龄分别为55.8 +/- 6.0岁和55.5 +/- 7.8岁，男性血清铁蛋白水平显著高于女性（p < 0.001）。股骨总、股骨颈和股骨粗隆的总体平均年损失率，女性分别为-1.14%/年、-1.17%/年和-1.51%/年，男性分别为-0.27%/年、-0.34%/年和-0.41%/年。在对潜在混杂因素进行调整后，在铁蛋白含量增加的四分位数类别中，男女股骨近端所有部位的骨质损失率均以剂量-反应方式显著加快（趋势p为0.043至< 0.001）。一致地，与铁蛋白含量最低的四分位数组相比，铁蛋白含量第三和/或最高的四分位数组的受试者，无论男女，股骨总和股骨颈的骨质流失都明显更快（p = 0.023至< 0.001）。总之，这些数据提供了第一个临床证据，表明即使在健康人群中，体内总铁储量的增加也可能是加速骨质流失的独立风险因素。(C) 2012年美国骨与矿物研究学会。
Despite extensive experimental and animal evidence about the detrimental effects of iron and its overload on bone metabolism, there have been no clinical studies relating iron stores to bone loss, especially in nonpathologic conditions. In the present study, we performed a large longitudinal study to evaluate serum ferritin concentrations in relation to annualized changes in bone mineral density (BMD) in healthy Koreans. A total of 1729 subjects (940 postmenopausal women and 789 middle-aged men) aged 40 years or older who had undergone comprehensive routine health examinations with an average 3 years of follow-up were enrolled. BMD in proximal femur sites (ie, the total femur, femur neck, and trochanter) was measured with dual-energy X-ray absorptiometry using the same equipment at baseline and follow-up. The mean age of women and men in this study was 55.8 +/- 6.0 years and 55.5 +/- 7.8 years, respectively, and serum ferritin levels were significantly higher in men than in women (p < 0.001). The overall mean annualized rates of bone loss in the total femur, femur neck, and trochanter were -1.14%/year, -1.17%/year, and -1.51%/year, respectively, in women, and -0.27%/year, -0.34%/year, and -0.41%/year, respectively, in men. After adjustment for potential confounders, the rates of bone loss in all proximal femur sites in both genders were significantly accelerated in a dose-response fashion across increasing ferritin quartile categories (p for trend 0.043 to < 0.001). Consistently, compared with subjects in the lowest ferritin quartile category, those in the third and/or highest ferritin quartile category showed significantly faster bone loss in the total femur and femur neck in both genders (p = 0.023 to < 0.001). In conclusion, these data provide the first clinical evidence that increased total body iron stores could be an independent risk factor for accelerated bone loss, even in healthy populations. (C) 2012 American Society for Bone and Mineral Research.